At last, consensus
is consolidating in the murky waters of gluten-related-illness.
Fifteen
international-celiac-doctors have put forward a consensus statement on the “new
nomenclature and classification of gluten-related-illness”.
I have
previously named this set of illnesses “The Gluten Syndrome”.
Here are
the 3 steps in my gluten logic:
Step ONE
a) If, gluten
sensitivity is common: perhaps affecting over 10% of the population);
b) If, gluten-related
illnesses are varied and have multiple symptoms: a quote from the consensus
paper emphasises this “The symptoms in GS may resemble
those associated with celiac disease (CD) but with a prevalence of
extra-intestinal symptoms, such as behavioral changes, bone or joint pain,
muscle cramps, leg numbness, weight loss and chronic fatigue. Their symptoms
include abdominal pain (68%); eczema and/or rash (40%); headache (35%); ‘foggy
mind’ (34%); fatigue (33%); diarrhea (33%); depression (22%); anemia (20%);
numbness in the legs, arms or fingers 20%; and joint pain (11%)”;
c) If, there
is no definitive diagnostic test for gluten sensitivity:
the Consensus paper goes on to say “However, currently there are no laboratory
biomarkers specific for GS. Usually the diagnosis is based on exclusion
criteria; an elimination diet of gluten-containing foods followed by an open
challenge is most often used to evaluate whether health improves with the
elimination or reduction of gluten from the patient's diet;
d) And if there
is no harm from going on a gluten-free diet; gluten-free is healthy.
Step TWO
Then the
logical conclusion is that anyone,
with any symptoms that are chronic and unexplained (that is they do
not have a definite diagnosis) should be put onto a gluten-free diet for a
clinical trial for three months or more.
Step THREE
Whatever
the test results and whatever the symptoms, a response to a gluten-free diet
suggests that their illness is gluten related (some people might demand a
double blind food challenge).
Comment
Up until
now, most gluten/celiac doctors have dismissed non-celiac patients as having a placebo
response to a gluten-free diet. This is
clearly not the case.
The above
logic means that all people with undiagnosed illnesses should be given a trial
of gluten-free. This is likely to have
huge health benefits and wide ramifications on the management of ill health.
Already 10%
of Australians are adopting a gluten-free diet.
It is my
prediction that in another generation most people who wish to remain well will
also adopt a gluten-free diet.
Thanks
Look forward to comment
Dr Rodney Ford
